Form Respm6 - Residential Offer To Lease Form

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RESPM6
RESIDENTIAL OFFER TO LEASE
UNIT # :
DEPOSIT:
.
LMR :
RENT:
.
TYPE:
PARK:
.
BUILDING:
COMMENCES:
EXPIRES:
.
ONE APPLICATION PER PERSON.
PLEASE PRINT
*(SUBJECT TO RENT REVIEW)
Mr.
Mrs.
Miss
Ms.
Mr.
Mrs.
Miss
Ms.
FULL NAME:_______________________________________
SPOUSE’S NAME:___________________________________
DATE OF BIRTH: __________/_____________/___________
DATE OF BIRTH: __________/_____________/___________
DAY
MONTH
YEAR
DAY
MONTH
YEAR
SOCIAL INSURANCE NUMBER: _____________________
SOCIAL INSURANCE NUMBER: ______________________
DRIVER LICENCE NUMBER: ________________________
DRIVER LICENCE NUMBER: _________________________
VEHICLE ___________/____________/_________/________
VEHICLE ___________/____________/_________/_________
MAKE
MODEL
YEAR
PLATE
MAKE
MODEL
YEAR
PLATE
#
#
CHILD(REN): 1)___________________
2) ____________________
3) _____________________
4)
__________________
ADDRESS ( Present & Previous)
PRESENT ADDRESS:
PREVIOUS ADDRESS
: ___________________________
_________________________________
CITY:___________________ POSTAL CODE ____________
CITY:_________________ POSTAL CODE : _____________
PROV.:___________ TELEPHONE NO.:_________________
PROV.:___________ TELEPHONE NO.:_________________
LENGTH OF TIME: _________
LENGTH OF TIME: _________
TENANT
OCCUPANT
TENANT
OCCUPANT
LANDLORD’S NAME & ADDRESS:
LANDLORD’S NAME & ADDRESS:
CONTACT PERSON: _________________________________
CONTACT PERSON: _________________________________
TELEPHONE NUMBER: ______________________________
TELEPHONE NUMBER: ______________________________
EMPLOYMENT (Present & Previous)
PREVIOUS EMPLOYER:
_________________________
PRESENT EMPLOYER:
_______________________________
ADDRESS: _________________________________________
ADDRESS: _________________________________________
TELEPHONE NUMBER:______________________________
TELEPHONE NUMBER:______________________________
POSITION HELD:____________________________________
POSITION HELD:____________________________________
SUPERVISOR’S NAME: ______________________________
SUPERVISOR’S NAME: ______________________________
: ________
: _________
: ________
: _________
MONTHLY INCOME
LENGTH OF TIME
MONTHLY INCOME
LENGTH OF TIME
EMPLOYMENT (SPOUSE)
PREVIOUS EMPLOYER:
PRESENT EMPLOYER:
_________________________
_______________________________
ADDRESS: _________________________________________
ADDRESS: _________________________________________
TELEPHONE NUMBER:______________________________
TELEPHONE NUMBER:______________________________
POSITION HELD:____________________________________
POSITION HELD:____________________________________
SUPERVISOR’S NAME: ______________________________
SUPERVISOR’S NAME: ______________________________
: ________
: _________
: ________
: _________
MONTHLY INCOME
LENGTH OF TIME
MONTHLY INCOME
LENGTH OF TIME
BANK - APPLICANT
BANK - SPOUSE
NAME:____________________________________________
NAME:____________________________________________
ADDRESS: ________________________________________
ADDRESS: ________________________________________
CHEQUING
SAVINGS
PCA
CHEQUING
SAVINGS
PCA
INSURANCE
NAME: _____________________________________________
ADDRESS: ________________________________________
The Leasee is advised to have insurance of personal belongings to include liability against property damage and bodily harm. We also recommend Tenant’s
Legal Liability Insurance for damage to the premises caused by the occupant(s) negligence.
EMERGENCY CONTACT
The applicant(s) agree(s) that the last month’s rent (LMR) deposit
paid to the Landlord upon making of this application and Offer to
Lease shall be forfeited to the Landlord if the applicant(s)
NAME: ____________________________________________________
withdraw(s) the application and Offer to Lease. If the Landlord
accepts the Offer to Lease, the deposit shall be retained as the last
ADDRESS: _________________________________________________
month’s rent and will be credited to the last month’s rent upon the
applicant(s) terminating their tenancy.
HOME #: _____________________ OFFICE #: ____________________
I/We warrant and confirm that the information given herein is
true and correct and I/We authorize(s) and consent(s) to the
RELATIONSHIP: ____________________________________________
receipt and exchange of credit information.
District Realty Corp.
50 Bayswater Avenue, Ottawa, ON, K1Y 2E9
TEL: 613-759-8383 FAX: 613-759-8448 EMAIL:

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